Clinical observation on treatment of spastic cerebral palsy with tuina plus music therapy

摘要

目的

观察小儿推拿结合音乐疗法对改善痉挛型小儿脑性瘫痪患者踝关节活动 度及下肢肌肉痉挛的作用。

方法

对符合小儿脑性瘫痪诊断标准的286 例痉挛型患儿, 在背景音乐下进行通督循经点穴推拿、 益肾健脾推拿、 捏脊疗法、 足底推拿、 节段性推拿、 促肌力恢复推拿及关节活动度推拿7 种推拿治疗, 每次25∼30min, 每日1∼2 次。 30 天为1 个疗程。 于治疗前后进行股内收肌角、 足背屈角和综合痉挛量表(Composite Spasticity Scale, CSS)评分, 以评价疗效。

结果

治疗前后足背屈角、 股内收肌角、 CSS 评分统计学处理, 差异有统计学意义(P<0.01)。 总体疗效为显效106 例, 有效172 例, 无效8 例。

结论

推拿结合音乐疗法治疗痉挛型小儿脑瘫, 有滑利关节, 松解肌腱挛缩, 缓解肌肉痉挛作用, 能改善剪刀步态和尖足步态。 对患儿坐、 跪、 站、 行大运动功能恢复有极积治疗作用。

Abstract

Objective

To observe the effect of tuina plus music therapy on range of motion of ankle joints and muscle spasm of lower limbs in children with spastic cerebral palsy.

Method

All of 286 cases that conformed to the diagnostic criteria of infantile cerebral palsy were treated with 7 types of tuina manipulations respectively to unblock the Governor Vessel, reinforce the kidney and strengthen the spleen, pinch along the spine, stimulate specific foot-reflex area and different spinal segments, accelerate recovery of muscle strength and increase joint range of motion, 25–30 min each treatment, once or twice a day, 30 d constitute a course of treatment. After this, the efficacy on femoral medial adduction and dorsiflexion angle and composite spasticity score (CSS) was evaluated.

Result

The statistical analysis showed significant differences in dorsiflexion and femoral medial adduction angle and CCS scores (P<0.01) after the treatments.

Conclusion

Tuina plus music therapy can lubricate the joints, relax contraction of tendons, alleviate muscle spasm and improve scissors and toe-walking gaits, thereby benefiting the gross motor function of infants in sitting, kneeling, standing and walking.